Our estimates show a pandemic with an Rt that is firmly, but perhaps only transiently, below 1, as a result of the half-term school holiday, following a sustained period of increasing infections that had been converging to a plateau. The pandemic data that we use typically inform incidence up until about two weeks ago. At this time, in five out of nine regions the probability that Rt is greater than 1 is in excess of 50%. The increase in the number of deaths tentatively identified last week has continued this week. Our model predicts this increase will continue for a further two weeks before an estimated peak around November 15th. This peak is at 186 deaths per day which is low in comparison to the peaks of the first two waves of infection.
Plots of the IFR over time show that from the end of January we estimate a decreasing IFR in all adult age groups, but most steeply in the older ages. This drop indicates the benefits of immunisation against death over and above the benefits against infection. Following this drop, there has been a period of plateau followed by a slight increase to 3.3% (3.1%–3.5%) in the over-75s and 0.27% (0.26%–0.28%) overall. The overall rate represents an increase on the previous week due to a smaller fraction of children becoming infected as a result of the school holiday. Our IFR estimates indicate the children have by far the best survival outcomes from CoVID.
For context, in addition to the data used here, the numbers of reported new positive tests this week (by date of specimen) has declined in comparison to the previous two weeks, though they are highly dependent on the volume and targeting of testing, the public’s testing behaviour and significant reporting delays, and therefore are difficult to interpret. Hospitalisations have started increasing once again, however, while the prevalence of infection, as estimated by the ONS Coronavirus Infection Survey, has instead risen consistently over the last six weeks to 1.9% in England: the highest level it has been in 2021 and close to the highest it has been during the lifetime of the survey.
Real-time tracking of an epidemic, as data accumulate over time, is an essential component of a public health response to a new outbreak. A team of statistical modellers at the MRC Biostatistics Unit (BSU), University of Cambridge, are working to provide regular now-casts and forecasts of COVID-19 infections and deaths. This information feeds directly to the SAGE sub-group, Scientific Pandemic Influenza sub-group on Modelling (SPI-M), and to regional Public Health England (PHE) teams.
We fit a transmission model (Birrell et al. 2020) to a number of data sources (see ‘Data Sources’), to reconstruct the number of new COVID-19 infections over time in different age groups and NHS regions, estimate a measure of ongoing transmission and predict the number of new COVID-19 deaths.
We use:
Data are stratified into eight age groups: <1, 1-4, 5-14, 15-24, 25-44, 45-64, 65-74, 75+, and the NHS England regions (North East and Yorkshire, North West, Midlands, East of England, London, South East, South West).
Value of \(R_t\), the average number of secondary infections due to a typical infection today.
The percentage of a given group that has been infected.
NB: negative growth rates are rates of decline. Values are daily changes.
| Region | Median | 95% CrI (lower) | 95% CrI (upper) |
|---|---|---|---|
| England | -0.03 | -0.03 | -0.02 |
| East of England | -0.04 | -0.06 | -0.02 |
| East Midlands | -0.04 | -0.05 | -0.02 |
| London | -0.01 | -0.03 | 0.00 |
| North East | -0.04 | -0.06 | -0.01 |
| North West | -0.04 | -0.06 | -0.01 |
| South East | -0.01 | -0.03 | 0.00 |
| South West | -0.03 | -0.04 | -0.02 |
| West Midlands | -0.04 | -0.06 | -0.03 |
| Yorkshire and The Humber | -0.05 | -0.06 | -0.03 |
Halving times in days, if a region shows growth than value will be NA.
| Region | Median | 95% CrI (lower) | 95% CrI (upper) |
|---|---|---|---|
| England | 26.13 | 21.29 | 36.15 |
| East of England | 19.38 | 12.07 | 38.81 |
| East Midlands | 17.76 | 13.05 | 35.79 |
| London | 53.58 | 21.07 | NA |
| North East | 19.28 | 11.12 | 54.61 |
| North West | 18.20 | 12.04 | 46.31 |
| South East | 47.17 | 23.33 | 310.39 |
| South West | 22.76 | 15.94 | 41.88 |
| West Midlands | 15.22 | 10.37 | 26.21 |
| Yorkshire and The Humber | 14.51 | 10.35 | 27.30 |
Doubling times in days, if a region shows decline then the value will be NA.
| Region | Median | 95% CrI (lower) | 95% CrI (upper) |
|---|---|---|---|
| England | NA | NA | NA |
| East of England | NA | NA | NA |
| East Midlands | NA | NA | NA |
| London | NA | 243.44 | NA |
| North East | NA | NA | NA |
| North West | NA | NA | NA |
| South East | NA | NA | NA |
| South West | NA | NA | NA |
| West Midlands | NA | NA | NA |
| Yorkshire and The Humber | NA | NA | NA |
NB: negative growth rates are rates of decline. Values are daily changes.
| Region | Median | 95% CrI (lower) | 95% CrI (upper) |
|---|---|---|---|
| England | 0.02 | 0.01 | 0.02 |
| East of England | 0.01 | 0.00 | 0.03 |
| East Midlands | 0.01 | 0.00 | 0.02 |
| London | 0.02 | 0.01 | 0.04 |
| North East | 0.00 | -0.02 | 0.02 |
| North West | 0.00 | -0.01 | 0.02 |
| South East | 0.03 | 0.02 | 0.05 |
| South West | 0.03 | 0.01 | 0.04 |
| West Midlands | 0.00 | -0.01 | 0.01 |
| Yorkshire and The Humber | 0.00 | -0.01 | 0.02 |
Halving times in days, if a region shows growth than value will be NA.
| Region | Median | 95% CrI (lower) | 95% CrI (upper) |
|---|---|---|---|
| England | NA | NA | NA |
| East of England | NA | 454.44 | NA |
| East Midlands | NA | 179.70 | NA |
| London | NA | NA | NA |
| North East | NA | 45.67 | NA |
| North West | NA | 62.08 | NA |
| South East | NA | NA | NA |
| South West | NA | NA | NA |
| West Midlands | NA | 54.98 | NA |
| Yorkshire and The Humber | 1282.11 | 52.98 | NA |
Doubling times in days, if a region shows decline then the value will be NA.
| Region | Median | 95% CrI (lower) | 95% CrI (upper) |
|---|---|---|---|
| England | 43.29 | 32.34 | 61.74 |
| East of England | 48.43 | 23.08 | NA |
| East Midlands | 78.42 | 28.37 | NA |
| London | 27.94 | 17.35 | 77.46 |
| North East | 387.97 | 32.53 | NA |
| North West | 449.45 | 37.90 | NA |
| South East | 20.04 | 14.28 | 34.15 |
| South West | 26.26 | 16.99 | 49.76 |
| West Midlands | 7768.57 | 47.64 | NA |
| Yorkshire and The Humber | NA | 45.83 | NA |
## The execution of the prevalence code block will proceed if
## prev.dat exists and this is TRUE
## it is not and external report and this is FALSE
The shaded areas show periods of national lockdown, the green lines the dates (once confirmed) of the steps in the roadmap in the UK Governement’s COVID-19 Response – Spring 2021, and the red line shows the date these results were produced (29 Oct).